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关键词： 儿科学   护理学   技术操作规程  

ISBN: (纸本)9787559116185

摘要： 本书共分七章，包括绪论、儿科护理管理规范、小儿内科疾病护理规范、小儿外科疾病护理规范、儿科常见肿瘤疾病护理规范、儿科急危重症护理规范、儿科护理技术操作规范。本书不包括新生儿护理的内容，新生儿是儿科特殊的群体，新生儿护理是儿科护理领域的重要亚专科，具体详见范玲主编的《新生儿护理规范》。本书以循证为基础，涵盖近年来儿科护理领域大量临床新知识、新理论、新技术，逻辑结构清晰，层次条例分明，语言深入浅出、简明扼要，注重知识的融合性和实用性。

关键词： Hidradenitis suppurativa   acne inversa   adolescents   children   epidemiology   pediatric age  

摘要： Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle affecting apocrine glands-rich areas of the body. The disease usually occurs after puberty leading to painful nodules, abscesses, tunnels and scarring. Although uncommonly, HS can also occur in children and adolescents. Objective Our objective was to describe the epidemiology, characteristics, predisposing factors and clinical course of HS in paediatric patients. Methods The retrospective cohort study included patients with HS, who have been diagnosed in Dessau Medical Center and reported development of HS during childhood or adolescence, fulfilled the diagnostic criteria for HS and had a follow-up period of at least one year. A systematic review was conducted on MEDLINE, EMBASE and CENTRAL on 19 March 2020 using the terms 'hidradenitis' or 'acne inversa' together with the terms 'children', 'paediatric' and 'adolescence'. Results Twenty paediatric patients [1 child (0.22%), 19 adolescents (4.25%)] were detected out of 447 patients evaluated (4.5%) with a male to female ratio of 1.86 : 1. The median age at diagnosis was 17 years [interquartile range (IQR) 16-18] and the median age at onset 15 years (IQR: 14-16.5). The majority of the patients suffered from moderate disease were overweight or obese and non-smokers. The most common comorbid disorder was acne vulgaris. The systematic review revealed reports with data heterogeneity and lack of systematic documentation of specific demographic characteristics. Most paediatric patients were female, obese and non-smokers, with considerable comorbid disorders. Conclusions Hidradenitis suppurativa in Germany may affect children and adolescents exhibiting a particular phenotype of mainly male non-smokers.

关键词： Analgesia   Paediatric   Outpatient   Pain   Survey   Distress  

摘要： The development of acute outpatient clinics has enabled burns services to assess the majority of smaller paediatric burns the day after injury. This event can be distressing and it is therefore important to ensure that children are initially assessed in an optimal environment. The aim of this study is to understand how small acute paediatric burns are managed across the British Isles. All paediatric burns services within the British Isles were contacted by telephone and information gained on how each unit manages new referrals of small acute paediatric burns in an outpatient setting. This national survey has shown that 5% total body surface area (TBSA) is generally considered to be the upper limit for new paediatric referrals to be seen in the outpatient setting 5%. Furthermore, we advocate that Paracetamol and Ibuprofen be given 60 min prior to an allocated appointment time. (C) 2020 Elsevier Ltd and ISBI. All rights reserved.

关键词： child nursing   qualitative approaches   critical care   nursing assessment   patient perspectives  

摘要： Aims To explore the meaning of comfort and know the factors that contribute to it from the point of view of the young adults who received care in a paediatric intensive care unit, the family of the patient and the interdisciplinary team attending the patient. Findings A total of 30 people were invited to participate in the focus groups;24 did so. Thematic analysis yielded the following common categories: meaning of comfort, environmental factors in paediatric intensive care unit, family accompaniment during paediatric intensive care unit stay, management of information in the paediatric intensive care unit and, finally, the intimacy and privacy of the critically ill paediatric patient and their family. Conclusions Paediatric intensive care unit professionals need to consider not only the environmental input that may lead to discomfort but also aspects such as continuous family accompaniment, the sharing of complete information with the family and the promoting of privacy.

关键词： COVID-19   SARS-CoV-2   acute lymphoblastic leukaemia (ALL)   chemotherapy   remdesivir  

关键词： Athlete's heart   paediatric   maturation   electrocardiogram   T-wave inversion   sudden cardiac death  

摘要： Background: International electrocardiographic (ECG) recommendations regard anterior T-wave inversion (ATWI) in athletes under 16 years to be normal. Design The aim of this study was to identify the prevalence, distribution and determinants of TWI by ethnicity, chronological and biological age within paediatric athletes. A second aim was to establish the diagnostic accuracy of international ECG recommendations against refinement within athletes who present with ECG variants isolated to ATWI (V1-V4) using receiver operator curve analysis. Clinical context was calculated using Bayesian analysis. Methods: Four hundred and eighteen Arab and 314 black male athletes (11-18 years) were evaluated by ECG, echocardiogram and biological age (by radiological X-ray) assessment. Results: A total of 116 (15.8%) athletes presented with ATWI (V1-V4), of which 96 (82.8%) were observed in the absence of other ECG findings considered to be abnormal as per international recommendations for ECG interpretation in athletes;91 (12.4%) athletes presented with ATWI confined to V1-V3, with prevalence predicted by black ethnicity (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.3-3.5) and biological age under 16 years (OR 2.0, 95% CI 1.2-3.3). Of the 96 with ATWI (V1-V4) observed in the absence of other ECG findings considered to be abnormal, as per international recommendations for ECG interpretation in athletes, diagnostic accuracy was 'fail' (OR 0.47, 95% CI 0.00-1.00) for international recommendations and 'excellent' (OR 0.97, 95% CI 0.92-1.00) when governed by biological age under 16 years, providing a positive and negative likelihood ratio of 15.8 (95% CI 1.8-28.1) and 0.0 (95% CI 0.0-0.8), respectively. Conclusion: Interpretation of ECG variants isolated with ATWI (V1-V4) using international recommendations (chronological age <16 years) warrants caution, but governance by biological age yielded an 'excellent' diagnostic accuracy. In the clinical context, the 'chance' of detecting car

关键词： 幼儿教育   科学活动   师幼互动   策略研究  

摘要： 幼儿在成长过程中,其与教师的互动对其身心健康的发展是非常重要的,并且师幼互动也是其在幼儿阶段接触非常多的关系之一,相对于正常授课,师幼活动的交流方式对幼儿的影响更大。在幼儿成长过程中,大部分时间都是由教师通过引导对其进行教育,因此,两者之间的互动对幼儿正确观念的形成非常重要。本文将通过简单讲述幼儿科学教育活动中的师幼互动的问题对互动策略进行研究。

摘要： Introduction The scope of practice of qualified dental hygienists and therapists allows them to undertake non-surgical periodontal screening, treatment and preventive care, and to diagnose and treatment plan. Therapists are also qualified to restore primary and secondary teeth, and to extract primary teeth. Both professions may see patients directly without needing a dentist's referral. In Scotland, they operate in a context of relatively poor but improving child oral health. Aim To investigate provision of dental care to children, including challenges encountered, by dental hygienists and therapists in the Scottish General Dental Service (GDS). Method An online survey of Scotland-based, GDC-registered dental hygienists and therapists in the GDS. Results Of 426 potential respondents, 194 (46%) responded, including 113 hygienists. Thirty hygienists and six therapists did not currently see child patients. Lack of referrals from dentists/specialisation by other team members, financial/contract reasons and lack of demand were the reasons given. Of those who did see children, most were therapists. Responsibility for preventive paediatric care was evenly split, with 71 (46%) citing the hygienist or therapist and 69 (45%) the dentist. Sixty-five (43%) reported barriers, most commonly relating to parents and children themselves. Time pressures, cost implications for practice and parents, and a number of practice and regulatory barriers were also mentioned. DiscussionThe response rate is considered to be very good. Limiting factors regarding provision of paediatric dental care include lack of referrals from GDPs and financial or contractual issues. Conclusion There appears to be considerable underuse of hygienists and therapists in respect to paediatric dental care.

摘要： ObjectiveTo gain insight into the reasons for children undergoing dental treatment under general anaesthesia in NHS Lothian. MethodsThis service evaluation was based on a representative sample size of 294 patients, randomly selected from the 1,236 children seen for dental general anaesthesia (DGA) during 2017 in NHS Lothian. Data on patient and treatment descriptors were collected retrospectively from clinical records and analysed to identify significant correlations. ResultsThe data indicated paediatric DGAs were mostly provided due to dental caries (88%, 260/294) and for children from the most deprived areas of Lothian. Most children were referred because they were of a very young age or had needs which precluded treatment under local anaesthesia (LA). Almost every child had teeth extracted under DGA (99%, 290/294) and a third of children received restorations (33%, 96/294). Discussion and conclusionThis study highlighted the disproportionate increased risk of dental caries and DGA in children from more deprived backgrounds, despite a nationwide reduction of children with caries experience. There is a need for more holistic, whole-system approaches to reduce child dental caries, with opportunities for collaborative work with local stakeholders to follow-up children who have had DGA. More research is needed locally and nationally to inform the translation of evidence into effective interventions.